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Updated: Sep 25, 2025
A Rapid Method for Multispectral Fluorescence Imaging of Frozen Tissue Sections
Published on: March 30, 2020
Identification of filigree pattern increases the diagnostic accuracy of micropapillary pattern on frozen section for
Shengnan Zhao1, Huikang Xie1, Hang Su2
1Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
Aims:
The presence of micropapillary (MIP) in early-stage lung adenocarcinoma is associated with a poorer prognosis, especially in patients undergoing sublobectomy. However, data on the sensitivity of frozen section (FS) evaluation of MIP is still limited. We included the concept of a filigree pattern on FS to assess its effect on the diagnostic sensitivity and specificity of MIP, and to verify its prognostic value in stage T1 lung adenocarcinoma.
Methods:
A panel of five pathologists evaluated 125 patients with T1 lung adenocarcinoma from January to February 2014 as a study cohort, and 151 patients from January to February 2020 as a validation cohort. The diagnostic accuracy of the filigree and classical micropapillary (cMIP) pattern on FS was investigated.
Results:
The diagnostic sensitivity of the MIP pattern on FS increased from 43.2% to 65.3% and 56.8% to 81.1% in the study cohort and validation cohort, respectively, and both with good specificity. Filigree not only increased the sensitivity of identifying MIP when there was an absence of cMIP, but also increased the sensitivity when the presence of a minor amount of cMIP. The almost perfect agreement among five pathologists was reached on cMIP and substantial agreement was reached on the filigree in the two cohorts. Moreover, the cMIP and filigree were both correlated with poorer recurrence-free survival (pcMIP = 0.003; pfiligree = 0.032) and overall survival (pcMIP = 0.004; pfiligree = 0.005).
Conclusions:
The identification of a filigree may improve the diagnostic sensitivity of the MIP pattern on FS. FS was feasible for the detection of filigree and cMIP patterns in stage T1 lung adenocarcinomas.
Insights
Identifying a filigree pattern on frozen sections improves diagnosis of micropapillary patterns in early lung adenocarcinoma. This method enhances detection sensitivity and confirms prognostic value for recurrence-free and overall survival.
Area of Science:
- Oncology
- Pathology
- Surgical Pathology
Background:
- Micropapillary pattern (MIP) in early lung adenocarcinoma correlates with poor prognosis, particularly after sublobectomy.
- Limited data exists on the sensitivity of frozen section (FS) for MIP evaluation.
- The filigree pattern's role in FS-based MIP detection and prognosis is underexplored.
Purpose of the Study:
- To assess the impact of a filigree pattern on FS for MIP detection sensitivity and specificity in stage T1 lung adenocarcinoma.
- To evaluate the prognostic significance of both filigree and classical MIP (cMIP) patterns on FS.
Main Methods:
- Five pathologists evaluated 125 (study cohort) and 151 (validation cohort) T1 lung adenocarcinoma cases using FS.
- Diagnostic accuracy of filigree and cMIP patterns on FS was investigated.
- Inter-pathologist agreement for cMIP and filigree patterns was assessed.
Main Results:
- FS diagnostic sensitivity for MIP increased significantly with filigree pattern inclusion (study cohort: 43.2% to 65.3%; validation cohort: 56.8% to 81.1%), with good specificity.
- Filigree pattern improved MIP detection sensitivity, even with minimal cMIP presence.
- Both cMIP and filigree patterns were significantly associated with poorer recurrence-free and overall survival.
Conclusions:
- Filigree pattern identification on FS can enhance diagnostic sensitivity for MIP in early lung adenocarcinoma.
- FS is a feasible method for detecting both filigree and cMIP patterns in stage T1 lung adenocarcinomas.
- These findings support the prognostic value of FS-based MIP and filigree pattern assessment.
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